Oral iron replacement is often poorly tolerated as evident by published studies where the adverse reaction rate has been reported to be as high as 80% [12], the discontinuation rate of up to 25% [16, 18]. Less than half of the patients were able to tolerate the prescribed dose of oral iron [14]. Some reports suggested oral iron therapy is associated with worsening of IBD disease activity [12], although not consistently [14]. Finally, there is controversy regarding whether or not oral iron replacement could exacerbate underlying disease through increased oxidative stress [18].